Issue |
J Extra Corpor Technol
Volume 50, Number 4, December 2018
|
|
---|---|---|
Page(s) | 256 - 259 | |
DOI | https://doi.org/10.1051/ject/201850256 | |
Published online | 15 December 2018 |
Case Reports
How to Manage Thrombocytopenia with ECLS: A Proposal of Clinical Reasoning Tools
* Département d'Anesthésie-Réanimation, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
† Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France
‡ Département d'Hématologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; and
§ INSERM, UMR_1148, Paris, France
Address correspondence to: Adrien Koeltz, MD, Département d'Anesthésie-Réanimation, APHP, Hôpital Bichat-Claude Bernard, 46 Rue Henri Huchard, Paris 75877, France. E-mail: adrien.koeltz@aphp.fr
Received:
1
August
2018
Accepted:
25
September
2018
Extracorporeal life support (ECLS) is increasingly used as a rescue therapy in patients with refractory cardiac/respiratory failure for temporary support or bridge to decision-making in both adult and pediatric patients. Complications such as bleeding and thrombosis remain major causes of morbidity and mortality in patients treated with ECLS. Hemostatic complications related to ECLS are multifactorial in patients with multiple organ dysfunctions and are incompletely characterized. Persisting thrombocytopenia and/or platelet dysfunction is the most frequent one. Herein, we report the case of a patient who developed severe thrombocytopenia after 5 days of ECLS associated with thrombi deposition in the circuit and oxygenator. After ECLS circuit and membrane change, we observed an increase and normalization in platelet count in 3 days. We propose a case-based reasoning to manage thrombocytopenia with ECLS.
Key words: extracorporeal life support / thrombocytopenia / thrombosis / hemocompatibility
© 2018 AMSECT
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.